Prior statin use is associated with improved outcomes in community-acquired pneumonia

Am J Med. 2008 Nov;121(11):1002-1007.e1. doi: 10.1016/j.amjmed.2008.06.030.


Background: Statins have potent anti-inflammatory effects in laboratory studies of pulmonary inflammation. We investigated whether statin users had improved outcome when admitted with community-acquired pneumonia.

Methods: We carried out a prospective observational study of patients admitted to the hospital with community-acquired pneumonia between January 2005 and November 2007. The use of statins, angiotensin-converting enzyme inhibitors, beta-blockers, and aspirin were recorded. The outcomes of interest were 30-day mortality, need for mechanical ventilation or inotropic support, and the development of complicated pneumonia.

Results: On multivariate logistic regression, statin use was associated with significantly lower 30-day mortality (adjusted odds ratio [AOR] 0.46, 95% confidence interval [CI], 0.25-0.85, P=.01) and development of complicated pneumonia (AOR 0.44, 95% CI, 0.25-0.79, P=.006). There was no effect on requirement of mechanical ventilation or inotropic support (AOR 0.93, 95% CI, 0.49-1.76, P=.8). Patients prescribed statins had more severe pneumonia (median Pneumonia Severity Index 4, interquartile range [IQR] 3-4) compared with patients not prescribed cardiovascular drugs (median Pneumonia Severity Index 3, IQR 2-4, P < .0001). Despite this, C-reactive protein levels on admission were significantly lower in patients prescribed statins (median 119 mg/L, IQR 46-215) compared with patients prescribed no cardiovascular drugs (182 mg/L, IQR 66-326, P < .0001). On multivariate logistic regression, statin use was independently protective against a C-reactive protein that failed to fall by 50% or more at day 4 (AOR 0.50, 95% CI 0.27-0.92, P=.02).

Conclusions: Statin use is associated with reduced markers of systemic inflammation and improved outcomes in patients admitted with community-acquired pneumonia.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • C-Reactive Protein / metabolism*
  • Cardiovascular Diseases / drug therapy
  • Community-Acquired Infections / complications
  • Community-Acquired Infections / metabolism
  • Community-Acquired Infections / mortality
  • Confounding Factors, Epidemiologic
  • Empyema, Pleural / etiology
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Male
  • Middle Aged
  • Pneumonia / complications
  • Pneumonia / metabolism
  • Pneumonia / mortality*
  • Prospective Studies
  • Respiration, Artificial
  • Scotland / epidemiology


  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • C-Reactive Protein